We have proposed five projects that together address many of the shortcomings in our understanding of how to measure, study and improve efficiency in healthcare. Core B is responsible for data management and analytic support for the data on which the five projects rest. To understand the causes and consequences of differences in the efficiency of healthcare, it is crucial to have: (1) a comprehensive database with sufficient power to characterize detailed patterns of healthcare utilization at the regional, hospital, physician and network levels, (2) a broad array of additional measures drawn from diverse sources that can augment these data, (3) the analytic capacity and oversight to ensure the timely preparation of analytic datasets, and (4) appropriate access to these resources for other investigators. We plan first to maintain a comprehensive and secure database of administrative data including Medicare and Medicaid enrollment files, claims records, and supplementary files. Second, we hope to obtain and manage additional data files required for this P01 and to develop subproject-specific analytic files. We will obtain data from a variety of sources, including the American Board of Internal Medicine, the Minimum Data Set of nursing home care, and Michigan and Texas Blue Cross Blue Shield data. Third, we seek to maintain a computing infrastructure and procedures capable of managing a high volume of patient identifiable, confidential data while ensuring timely and appropriate access to authorized investigators. And finally, we plan to make the research files developed under this P01 available to the research community to the extent permissible under law.

Public Health Relevance

Medicare, Medicaid and private health plans are all moving toward payment systems intended to reward value: better care and lower costs. This Core is intended to acquire, maintain, and disseminate comprehensive data with innovative measures of cost and quality based on all three payers. These data will be used to study productivity gaps and opportunities to improve efficiency of healthcare.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Program Projects (P01)
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Special Emphasis Panel (ZAG1-ZIJ-1 (01))
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Dartmouth College
United States
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Colla, Carrie H; Lewis, Valerie A; Kao, Lee-Sien et al. (2016) Association Between Medicare Accountable Care Organization Implementation and Spending Among Clinically Vulnerable Beneficiaries. JAMA Intern Med 176:1167-75
Bekelis, Kimon; Gottlieb, Daniel; Newhall, Karina et al. (2016) Does Rapid Diffusion of HbA1c Testing Affect Amputation Rates? Vasc Endovascular Surg :
Chang, Chiang-Hua; Bynum, Julie P W; Onega, Tracy et al. (2016) Screening Mammography Use Among Older Women Before and After the 2009 U.S. Preventive Services Task Force Recommendations. J Womens Health (Larchmt) 25:1030-1037
Yang, Mia; Chang, Chiang-Hua; Carmichael, Donald et al. (2016) Who Is Providing the Predominant Care for Older Adults With Dementia? J Am Med Dir Assoc 17:802-6
Koller, Daniela; Hua, Tammy; Bynum, Julie P W (2016) Treatment Patterns with Antidementia Drugs in the United States: Medicare Cohort Study. J Am Geriatr Soc 64:1540-8
Moen, Erika L; Austin, Andrea M; Bynum, Julie P et al. (2016) An analysis of patient-sharing physician networks and implantable cardioverter defibrillator therapy. Health Serv Outcomes Res Methodol 16:132-153
Sahni, Nikhil R; Dalton, Maurice; Cutler, David M et al. (2016) Surgeon specialization and operative mortality in United States: retrospective analysis. BMJ 354:i3571
Wallaert, Jessica B; Nolan, Brian W; Stone, David H et al. (2016) Physician specialty and variation in carotid revascularization technique selected for Medicare patients. J Vasc Surg 63:89-97
Nagendran, Myura; Dimick, Justin B; Gonzalez, Andrew A et al. (2016) Mortality Among Older Adults Before Versus After Hospital Transition to Intensivist Staffing. Med Care 54:67-73
Bekelis, Kimon; Gottlieb, Dan; Su, Yin et al. (2016) Medicare expenditures for elderly patients undergoing surgical clipping or endovascular intervention for unruptured cerebral aneurysms. J Neurointerv Surg :

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